San Jose Rejects Universal Child Health Care

SAN JOSE —  City leaders Tuesday slammed the brakes on a proposal to make this metropolis in the heart of the Silicon Valley the nation’s first to provide universal health insurance for children.

A split City Council narrowly rejected the proposal to tap about $2 million a year in tobacco settlement money to help provide health coverage for the 37,000 children now without it in the city.

Instead, the council agreed to a plan pushed by Mayor Ron Gonzales for a detailed study of the health proposal, along with other projects vying for the tobacco funds.

Boosters of the health plan said the move seemed intended to quietly kill the initiative.

“I don’t think children’s health insurance is a priority for the mayor,” said Bob Brownstein of Working Partnerships USA, a labor-backed research group supporting the proposal. “But this battle is not over. Nobody has given up on children in San Jose.”

The push for comprehensive care, spurred by organized labor and local churches, called for the city to provide about a third of the estimated $6 million a year needed to augment existing government programs for children of poor families. The remaining funds are being sought from Santa Clara County and private foundations, which have not yet committed to the plan.

As envisioned by boosters, the health proposal would have included a push to enroll more people in established state and federal health programs. It also would have subsidized premiums for the poor. Finally, the plan sought to help families ineligible for government aid pay for private insurance.

The council heard four hours of testimony from the public Monday night and then juggled the proposal among themselves for nearly two hours Tuesday. At times the discussion was testy.

“I don’t appreciate the implication that I would care less than someone else about children,” said Vice Mayor Frank Fiscalini, who supported a delay to study the health issue further. He said the insurance proposal represented an “important public policy issue” that should not be decided “with emotions.”

But emotions were very much in evidence. Councilman Manny Diaz said he had grown up without health insurance. His mother relied on home remedies for his frequent ear problems. As a result, he said, his hearing as an adult is poor.

“I’m still suffering because we didn’t have preventative care,” said Diaz, who backed the health insurance proposal. “I can relate. For me to not support this is crazy.”

The health initiative was meant to address a nagging problem for the Silicon Valley. In this land of plenty, where dot-com millionaires are made overnight and housing costs have soared to the highest levels in the nation, nearly 70,000 children in Santa Clara County are without health insurance.

Boosters of universal coverage for children proposed to capitalize on San Jose’s share of the cash windfall reaped by municipalities and states across the country from lawsuits against the tobacco industry.

Santa Clara County is expected to receive more than $18 million annually, and San Jose is to get $10 million a year.

Although the proposal attracted nationwide media attention, it failed to win universal acceptance in San Jose.

Gonzales, in particular, quickly soured on the idea, questioning whether the city should get into health care issues normally handled by the county. A majority of the council, however, vowed to support the children’s insurance proposal when it was unveiled last month.

But that fragile coalition collapsed a week ago. Councilwoman Pat Dando reversed course, saying she believed the proposal needed more study. She cast the deciding vote in a pair of 6-5 decisions that dashed hopes of health plan supporters.

Her change of mind angered the plan’s boosters, who suggested that Dando--who challenged Gonzales for mayor in 1998--might have struck a deal with her longtime foe. Gonzales has proposed spending $2.3 million on projects in Dando’s district this year, compared with just $25,000 last year.

Dando rejected charges that she made a deal. On Tuesday, she noted that the state is awash in money and looking to provide universal health funding for children in California. She said everyone agrees that children’s health care is important, but that the city had “gone astray” in focusing right away on dollar amounts.

The proposal, she said, “needs thoughtful consideration and additional study.”

Though known for microchip manufacturers and Internet start-ups, the Silicon Valley has a huge pool of service workers who keep the place running--gardeners, restaurant workers, housecleaners and nannies, security guards, cashiers. Many lack health insurance.

The nature of the high-tech industry--rapid innovation, shifting product lines, layoffs--has also created health insurance problems for the working poor. Many companies survive with a work force of temporary hires who are given few or no benefits.

The central thrust of the insurance proposal was to boost efforts to enroll eligible children in existing programs--such as Medi-Cal and the state’s Healthy Families program. A family can earn as much as $42,000 and be eligible for such state and federal programs.

About two-thirds of the uninsured children in Santa Clara County qualify for government insurance, but their parents haven’t applied. Though the application process has been streamlined, some chafe at the bureaucracy, officials say. Others are too proud to take government handouts.

But much of the money for the San Jose plan, about $4 million a year, would go to subsidize health insurance premiums and policies for children of the working poor and immigrants who are not eligible for existing programs.

Some families make too much to qualify for government programs but still cannot afford coverage because of the Silicon Valley’s high living costs. Health insurance, they say, seems a luxury when a family has to pay the rent and put food on the table and clothes on their children.

And new immigrants often are ineligible for state and federally funded programs.